Some causes include:
- Making too much milk near the end of the first week of lactation. This means your body does not know how much milk your baby will need, so it produces extra. This usually gets better as baby gets older.
- Too much pumping. This can be before or after feeding, or when you are away from your baby.
- Switching sides (left and right) often or on a timed schedule.
- Having a large number of alveoli (milk sacs). This affects how fast you make milk. This can vary quite a bit. There is no routine test to know how many alveoli you have.
- Baby starts taking solids, therefore breastfeeding less.
- Full, uncomfortable breast even after feeding.
- Leaking a lot of milk between feedings.
- Sore nipples. It may be hard for baby to get or keep a deep latch.
- Forceful letdown, which may be painful.
- Milk sprays when baby comes off the breast.
- Frequent blocked ducts or mastitis. There may be shooting pain deep in the breast.
- Frequent choking, coughing or sputtering during feeding.
- Biting or clamping down on the nipple to slow the flow.
- Short restless feedings – five to 10 minutes, arching back, latching off and on.
- Frequent burping and gas between feedings.
- Large green, frothy stools.
- Frequent spitting up between feedings.
- Rapid weight gain – more than one ounce a day over several days.
- Gaining weight but not content between feedings.
- Fully empty the first breast before changing to the second. This balances the fluid, nutrients and fat in the milk. It also keeps the second breast from making so much milk.
- Practice block feeding for a week.
- Divide the day into three-hour time periods.
- Only feed from one side during this time period.
- Example: From 9 a.m. to noon, feed only on the left breast. Then from noon to 3 p.m., feed only on the right breast. Keep changing breasts every three hours.
- Be careful if the opposite breast is very uncomfortable. You can hand express or pump a very small amount to relieve pressure. But too much hand expression or pumping will make the problem worse.
- Wear a supportive (but not tight) bra.
- Talk to your doctor about herbs and medicines that may help.
- Check your breast daily (or more often) for signs of blocked ducts and mastitis.
- Position baby to feed in a sitting position. Change the football hold by pulling baby forward. Baby should be sitting facing the breast.
- Position baby to feed with mom leaning back or under baby. This lets gravity slow the force and flow of milk.
- Make sure baby can move the head when feeding. If the flow is fast, baby may need to quickly release the latch.
- Feed before your baby gets too hungry. If baby sucks too hard, it can force the milk out too fast.
- Burp baby often during feedings.
- A lactation consultant may recommend a nursing shield to slow the flow of milk.
It should improve in four to seven days. If you continue to have concerns at any time, call a lactation consultant or your pediatrician.